Get to Know How Blue KC Chooses Your Network of Healthcare Providers.
How does a plan select network physicians?
Blue Cross and Blue Shield of Kansas City (Blue KC) selects all physicians for our networks through a credentialing and contracting process. Once Blue KC approves providers who meet the criteria established in our process, they are included in our provider networks. Setting standards for participating providers is part of our commitment to bring you quality healthcare coverage.
Is my physician in the Blue KC provider network?
You can easily check the provider directory for your network on our website to see whether your physician is a participating provider. Because healthcare providers in your network may change, we recommend that you verify your provider’s participation before you receive care.
Besides physicians, what can I find in the provider directory?
Through the provider directory, you can also search for healthcare hospitals, facilities (e.g., home health facilities), labs and pharmacies.
What does it mean when a physician says he or she isn’t accepting new patients?
When you look up a provider and the description says, "Accepting new patients?," followed by a “no” answer, it means that a physician is not taking new patients at that time, and he or she is only treating current patients seen within a one-year period.
How current is the provider directory?
The online provider directory is updated daily; however, agreements with providers can change throughout the year. Always ask the provider if he or she is in your provider network before you receive care.
How can I obtain a hard copy of the provider directory?
To request a hard copy of the provider directory, Contact Us or call 1-800-810-4600. Please let us know your member ID number, mailing address, a home phone number and your date of birth. If you know the name of your health insurance plan or network directory that you are requesting, please include that information as well.
What is BlueCard®?
BlueCard is a national provider program offered by Blue KC and other Blue Cross and/or Blue Shield Plans across the country. This program provides in-network benefits to PPO members who need healthcare services when they are away from home.
How can I access a PPO BlueCard provider away from the Kansas City area?
If you are traveling out of the Blue KC service area and need to access a provider, call 1-800-810-BLUE. We will provide you with the name and address of a participating provider. If you need a provider directory from another health insurance plan, please call the Customer Service number on your member ID card. You can also visit the BlueCard Doctor and Hospital finder to find providers in this program.
How can I access a HMO provider away from Kansas City?
If you’re an HMO member, you will need to receive services from an in-network HMO provider. However, you will be able to receive emergency or urgent care services no matter where you are. For details about your coverage, review your Blue KC certificate, which outlines the benefits and exclusions related to your health insurance plan.